Financial Benefits of Empowered Kidney Care
There is a clear link between empowered kidney care practices and improved outcomes and experiences. Self-care dialysis saves lives, but what about cost?
Data from a 4-year study in central Texas clearly shows that the qualitative improvements of empowered care come hand-in-hand with quantitative benefits as well. Payers see significant savings from reduced hospitalizations, and healthcare providers see reduced costs and new revenue opportunities with cost sharing, and everyone wins when mortality rates are reduced.
The numbers speak for themselves…
Case Study: Central Texas Nephrologists
Over a period of four years from 2015-2018, Dr. Richard Gibney and his team took on a mission to convert 11 clinics in central Texas to an empowered in-center self-care dialysis system. Over the four year period, they collected data and steadily increased the percentage those performing self-dialysis to include over 500 patients.
In the early years, the data favors empowered patients, likely due to a selection bias of healthier patients choosing to participate in the new self-care program. However by years 3 and 4, a clear trend has developed in empowered patient results. By that point, the program was accepting patients from all walks of life, including those labeled “non-compliant” and rejected by other clinics, proving without a doubt, that patient empowerment is for everyone.
By the end of the four year trial period the benefits were unmistakable, even when considering the numbers for the entire unit, which still include 32% conventional ICHD patients.
Savings from Reduced Hospitalization Rate for Payers
Throughout the study, empowered patients experienced less than one average hospitalization per year (.88), cutting the national average of 1.7 nearly in half. Together, the clinics’ combined average hospitalization rate was .1.5 per year, 12% less than the national average.
National Average: 1.7
Empowered Patient 4-Year Average: 0.88 (48% reduction)
Entire Unit 4-Year Average: 1.50 (12% reduction)
Not only do reduced hospitalizations represent a better experience for the patients, but they translate to significant cost savings as well. Each hospitalization for a hemodialysis patient is assumed to cost around $25,000. A recent comparison of data from Arizona, California, and Texas revealed the average cost to be over $30,000 for those states.
Projected annual savings for payer: $20,500 per empowered patient*
*Per-patient savings assume empowered annual hospitalization rate of .88 per patient and an average hospitalization cost of $25,000 per visit.
Projected annual savings for payer: $4,000,000 for a unit with 800 patients**
** Per-unit savings assume a group of 800 patients with an entire unit average annual hospitalization rate of 1.50 per patient and an average hospitalization cost of $25,000 per visit.
These numbers represent huge savings for government payers (Medicare/Medicaid) and therefore a significant impact on taxpayers.
Financial Benefits of Reduced Hospitalization for Providers
Of course, hospitalizations also represent disruption and lost revenue for dialysis centers. Data from 2017 shows that hemodialysis patients are hospitalized, on average, for more than 11 days each year. This represents multiple missed treatments. Nephrologists must also allocate time for travel and visiting hospitalized patients.
When we consider the impact of patient empowerment on hospitalizations, it is easy to see how even a little goes a long way. By educating patients with a better understanding of their own care, they can be more aware of their condition and anticipate symptoms before they become a problem.
Additionally, self-care centers see better results because they can allow for patients to fit dialysis into their own schedule. Studies clearly show that skipping just one extra day between treatments leads to a large increase in mortality and hospitalizations. We’ve known for a long time that mortality rates go up over the weekend when people wait two days between treatments.
Empowered Self-Care Dialysis Saves Lives
Every year during the study, the mortality rate for empowered patients was over 50% lower than the national average. All together, the clinics’ combined mortality rate was 31% lower than the national average.
National Average: 16%
Empowered Average: 5.2% (68% reduction)
Clinic Average: 11.7% (27% reduction)
Everyone wins when mortality rates decrease. Healthcare providers benefit from lower patient turnover, and patients get to live longer, more fulfilling lives thanks to empowered kidney care.
Projected lives saved each year: 34 for a unit with 800 patients***
*** Per-unit lives saved assume a group of 800 patients with an entire unit average mortality rate of 11.7%.
Staffing Benefits from Empowered Care
It’s no secret that traditional dialysis centers can create high-pressure work environments as doctors, nurses, and technicians are pushed for speed and quantity.
High staff turnover represents a significant cost to every practice. Days or weeks of productivity are lost every time a staff member must be hired and trained, and quality suffers.
Staff burnout is harder to measure but is just as disruptive. How much productivity is lost when a staff member loses focus and inspiration? How many colleagues and patients alike are negatively impacted by a staff member who is obviously stressed and agitated?
Shared Cost Reduction
With the advent of new government initiates around kidney care, nephrology in America is seeing a culture shift. Where CMS was once focused on quality ratings, it now emphasizes outcomes, like avoiding hospitalizations and infection-prone dialysis catheters.
Dialysis centers are shifting from a revenue-per-chair volume based approach and looking towards the benefits of shared cost saving benefits. Fast “assembly line” dialysis is no longer the name of the game. Forward-thinking organizations and nephrologists must look to innovative practices like self-care dialysis to stay competitive and create new revenue opportunities.
The Future of Kidney Care Starts Today
At the end of the day, empowered care is about putting patients first. Both outcomes and experience improve when we treat patients with dignity and allow them to take control over their own care… all at no extra cost to payers or healthcare providers.
If you’d like to learn more about how empowered kidney care practices can benefit your organization, don’t hesitate to reach out to us. We have successfully empowered hundreds of patients and caretakers and we want to help your clinic too.